Pannus is a medical term for a hanging flap of tissue. When involving the abdomen, it is called a panniculus and consists of skin, fat, and sometimes contents of the internal abdomen as part of a hernia. A pannus can be the result of loose hanging tissues after pregnancy or weight loss. It can also be the result of obesity which unfortunately is becoming more and more widespread in society. A pannus can come in many different sizes and shapes and can become very large, even hanging down below the knees. The extra tissue of a hanging pannus can make personal hygiene difficult. Skin conditions such as yeast infections under the pannus are common problems since the tissue under the pannus is not properly exposed to air but rather is a warm, moist area where bacteria thrive. A massive hanging pannus can get in the way of walking and prevent a person from performing many of life's daily tasks. A smaller pannus can be an annoyance with clothing as the individual sits or stands.
In term of abdominal panniculi, a grading system has been developed to better assist the physician in classifying the degree of the pannus. The grading system is as follows: grade 1: panniculus barely covers the hairline and mons pubis but not the genitalia; grade 2: extends to cover the genitalia; grade 3: extends to cover the upper thigh; grade 4: extends to cover the mid thigh; and grade 5: extends to cover the knees or beyond.
One situation where a pannus is particularly troublesome and must be properly dealt with is during the delivery of a child from an obese woman. It is generally understood that the term “obese” actually refers to anyone who is more than 30% over their ideal body weight. Obesity can be the result of many factors, including inactivity, poor diet, and certain health-related complications. Obesity is becoming a growing concern among both genders and all age groups. In 1962, 13% of the American population was classified as obese. By 1994, this number had increased to 23%. Yet, just six years later in 2000, this number had skyrocketed to over 30%. Today, an estimated two-thirds of Americans are considered overweight while one in three is obese. As a result, in America, being obese has officially become a marker for classifying a pregnancy as high risk.
Of particular concern for women of childbearing age are the effects that obesity can have on your reproductive health. Obesity put you and your baby at risk for some serious health complications. If a person is obese during pregnancy, the person is at risk of several serious health complications, including: (a) preeclampsia which is a condition which causes high blood pressure, fluid retention, and swelling during pregnancy (When serious, preeclampsia can restrict placental blood flow, endangering baby); (b) gestational diabetes is a form of diabetes that develops during pregnancy and prevents the body from breaking down sugar and can put the baby at risk for gaining too much weight in utero; (c) cesarean section: women who are obese during pregnancy have an increased risk of experiencing problems during delivery and labor is more likely to be slow and prolonged, increasing the likelihood of cesarean section; (d) postpartum infection: Obesity during pregnancy also makes a woman more vulnerable to experiencing a difficult postpartum recovery and in particular, if a woman had a c-section, they are at risk for developing dangerous postpartum infections.
The presence of a pannus during a cesarean section surgical procedure complicates the overall process and additional procedures must be followed to prepare the woman for surgery. As is know, in a conventional cesarean section surgical procedure, after the skin is thoroughly cleansed with an aseptic solution and sterile drapes spread over the surgical field, the abdomen is entered by making an incision through all the layers of the abdominal wall: the skin, the fat and then several muscle layers and muscle sheaths (fascia). This incision can be made either vertically below the umbilicus like a zipper, or horizontally right above the pubic bone, a “bikini cut.” Usually all the intestines have been pushed up into the upper abdomen by the enlarged uterus and the uterus lies directly against the abdominal wall. Next, the incision through the muscle wall of the uterus is made and stopped just short of the amniotic sac that contains the baby. The amniotic sac is ruptured carefully, so as not to hurt the baby, and the baby is delivered much as if she were coming out through the vagina.
Recent studies have found that maternity units are not particularly well equipped for obese pregnant women. Presently, fairly crude techniques are used to deal with obese pregnant women that have a pannus that is obstructing the abdomen area where the cesarean section is to be performed. For example, in order to push the pannus back and hold the pannus away from the underlying tissue where the cesarean incision is to be made, an elongated band, such as adhesive tape or the like, is attached to the lower abdomen above the incision on either side and is pulled up and back with sufficient force to lift the pannus away from the underlying tissue, and the other end of the band is fixedly attached to another structure. The structures to which ends of the band are attached can be legs of the bed or other fixtures in the operating room. Once the pannus is lifted, the surgical procedure continues. After delivery of the baby, the incision is closed up and the patient is brought to a recovery room. Unfortunately, the pannus is let to hang back over the incision. As mentioned above, the hanging of the pannus over the incision provides a warm, moist area where bacteria thrive and proper healing is more difficult.
It will be appreciated that while a cesarean section is described herein as being a surgical procedure that is complicated by the presence of a pannus, any surgical procedure where an incision is made in the abdomen or proximate area that is covered by a pannus is equally complicated by the presence of the pannus.
There is therefore a need to provide a pannus support member or adapter that is designed not only to be worn prior to a surgical procedure, such as a cesarean section, but also after it during the recovery period.